Laparoscopic gallbladder removal
Definition
Laparoscopic gallbladder removal is surgery to remove the gallbladder using a medical device called a laparoscope.
The gallbladder is an organ that sits below the liver. It stores bile, which your body uses to digest fats in the small intestine.
Alternative Names
Cholecystectomy - laparoscopic; Gallbladder - laparoscopic surgery; Gallstones - laparoscopic surgery; Cholecystitis - laparoscopic surgery
Description
Surgery using a laparoscope is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets your surgeon see inside your belly.
Gallbladder removal surgery is done while you are under general anesthesia so you will be asleep and pain-free.
The operation is done the following way:
- Your surgeon makes 3 to 4 small cuts in your belly.
- The laparoscope is inserted through one of the cuts.
- Other medical instruments are inserted through the other cuts.
- Gas is pumped into your belly to expand the space. This gives your surgeon more room to see and work.
The gallbladder is then removed using the laparoscope and other instruments.
An x-ray called a cholangiogram may be done during your surgery.
- To do this test, dye is injected into your cystic duct so that it flows into the common bile duct and an x-ray picture is taken. The dye helps find stones that may be in the common bile duct.
- If other stones are found, your surgeon may remove them with a special instrument.
Sometimes your surgeon cannot safely take out the gallbladder using a laparoscope. In this case, your surgeon may use open surgery, in which a larger cut is made.
Why the Procedure Is Performed
You may need this surgery if you have pain or other symptoms from gallstones. You may also need it if your gallbladder is not working normally.
Common symptoms may include:
- Indigestion, including bloating, heartburn, and gas
- Pain after eating, usually in the upper right or upper middle area of your belly
- Nausea and vomiting
Most people have a quicker recovery and fewer problems with laparoscopic surgery than with open surgery.
Risks
Risks for anesthesia and surgery in general include:
- Reactions to medicines
- Breathing problems
- Bleeding, blood clots
- Infection
Risks for gallbladder surgery include:
- Damage to the blood vessels that go to the liver
- Injury to the common bile duct
- Injury to the small intestine or colon
- Inflammation of the pancreas (pancreatitis)
Before the Procedure
You may have the following tests done before your surgery:
- Blood tests (complete blood count, electrolytes, and kidney tests)
- Chest x-ray or electrocardiogram (ECG), for some people
- CT scan of the abdomen, showing the liver and the gallbladder
- Ultrasound of the gallbladder
Tell your surgeon if:
- You are or could be pregnant
- You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
- You have been drinking a lot of alcohol, more than 1 or 2 drinks a day
Planning for your surgery:
- If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions.
- If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
- If needed, prepare your home to make it easier to recover after surgery.
- Ask your surgeon if you need to arrange to have someone drive you home after your surgery.
During the week before your surgery:
- You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
- Ask your surgeon which medicines you should still take on the day of your surgery.
- Prepare your home for any problems you might have getting around after the surgery.
- Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.
On the day of surgery:
- Follow instructions about when to stop eating and drinking.
- Take the medicines your surgeon told you to take with a small sip of water.
- Shower the night before or the morning of your surgery.
- Follow instructions on when to arrive at the hospital. Be sure to arrive on time.
After the Procedure
If you do not have any problems, you will be able to go home when you are able to drink liquids easily and your pain can be treated with pain pills. Most people go home on the same day or the day after this surgery.
If there were problems during surgery, or if you have bleeding, a lot of pain, or a fever, you may need to stay in the hospital longer.
Outlook (Prognosis)
Most people recover quickly and have good results from this procedure. It may take up to a week to get you normal energy back.
References
Bonds M, Rocha F. Cholecystectomy techniques and postoperative problems. In: Jarnagin WR, Allen PJ, Chapman WC, et al, eds. Blumgart's Surgery of the Liver, Biliary Tract and Pancreas. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 36.
Radkani P, Hawksworth J, Fishbein T. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 55.
Reviewed By: John Meilahn, MD, General Surgeon, Wyndmoor, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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